Provider Demographics
NPI:1427657303
Name:SHEEHAN, MOLLIE M
Entity type:Individual
Prefix:
First Name:MOLLIE
Middle Name:M
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 SHERIDAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-8104
Mailing Address - Country:US
Mailing Address - Phone:720-799-7663
Mailing Address - Fax:
Practice Address - Street 1:410 SHERIDAN BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-8104
Practice Address - Country:US
Practice Address - Phone:720-799-7663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst